SH6053 Challenges Facing the Implentation of Universal Healthcare in South Africa

The healthcare system of specific country is required to be strong and sufficient enough so that it will provide support to every sick individual in order to fulfil their actual needs to achieve better health status. For people who can't afford to obtain the required care from private health care, the government take steps to provide free or limited cost health care. They also considered that the health should be of good quality and ensure that the high cost of services will be controlled or removed (Howson and et. al., 2018). The government provides health care services to all the people by collaborating with other healthcare systems such as national health insurance scheme of South Africa. This insurance health care system works to provide the affordable health services to all the citizens of South Africa. The health care system works on ethics and rules by collecting and analyzing the data. The aim of this health care system is to promote the health by promoting some other activities that can influence the people to make healthy choices for a healthy life. It includes the accessing and implementation of new technologies which can help the individual to attain a good healthy life. The public sector doesn't help the individuals in a large numbers, so the government helps to put the effective health care in place for the citizens.

The aim of a health care system is to provide the full medical and health needs to the people. There are some ethics principles which consist factor of autonomy which should be followed by care practitioners to deliver better care services for well-being of patients. But the government sector of South Africa faces many problems in developing autonomy as the government has poor record keeping or infrastructure which makes the difficulties for the patient to make autonomous decisions. It is observed that inaccurate government infrastructure is responsible for poor clinical procedures due to which care professionals did not engage patients in decision making of their treatment. This dissertation will focus on the implementation of health requirements by health care system to all citizen.

1.2 The Significance and Aim

The aim of this research is “To analyze the challenges faced in relation to implementation of universal healthcare in South Africa. A case on healthcare industry.”

The given study is significant as it facilitates to understand about challenges and issues in terms of applying health care system to overcome them. Though South Africa is famous for having progressive constitution with powerful protection of human rights and all citizen right to evaluate quality of healthcare delivery, there are some challenges facing the country that are covered in this research are as explained here.

Unequal distribution of resources

It is caused by rapid urbanization of South Africa with health facilities in urban areas having been planned and reinforced to cater for an existent total grouping. The abrupt inflow of people into cities social unit results in health services not being able to function on the far side capacities. This has led to gathering and deficiency of beginning and added deformation on an already overtaxed healthcare system (Moyo and et. al., 2018). It is unconstitutional to contradict anyone accession to basic healthcare services, even unregistered migratory population. The shortage of healthcare workers, caused by inadequate production and recruitment, poor retention and staff mismanagement in overall world issues.

As well as the other issues because of unequal distribution healthcare workers between the well origin private plane figure and the poorly origin public sphere and between the urban and rural region (Knijn and Patel, 2018). The deficit of staff is mostly felt at nursing level because health professional are in the advanced line of work delivery in health care.

The significance of given study is to identify basic issues and problems which impacts negatively on entire health system of selected country. It is very important to determine actual issue and its cause to overcome with the same effectively. Meanwhile, it is important to evaluate the threats of healthcare system of the nation so that care practitioners can put efforts towards the same for delivering appropriate medical facilities for achieving wellness of citizens.

Management and leadership crisis

The health outcomes report in South Africa signal a complete non achievement in public sector healthcare bringing, with consequences worsened than that of some let down financial gain countries caused by poor leadership and incapable management, and uninflected in deficient of sight, lack of clear humanities and poor goal setting (Prey and et. al., 2016).

The importance of this investigation to defeat the trouble faced by South Africa in healthcare management. The leadership crises can be copied back to primal days of political theory, following the implementation of government policies to improve living conditions in poor households. One of the tasks of democratic government was to transform the public service by removing all discriminatory practices and policies in the employment line through implementation of equity.

Increased Disease Burden

South Africa is attempting to confront the high burden of disease and seems to be failing to manage it. The severe consequence of HIV and AIDS in Africa has desolate healthcare systems to the extent that they are unable to cope with demands of high quality delivery. These diseases have epidemics concurrent with high burden of tuberculosis, high maternal and child mortality, high level of violence & injuries and non-contagious diseases such as diabetes, chronic respiratory conditions and cancer (Yamin, 2017).

To overcome these problems by self and active management. It affect taking obligation for their behavior and changing their lifestyle by focusing on physical, emotional, mental social needs in order to reminder and manage illness and encourage well-being. And authorize patients by rising self-authority to upgrade healthy lifestyles.

1.3 Research Background

The health care system of South Africa is basically divided into two health care systems being the public and private sector. There is a large divide between the both sectors as they provide health care services accordingly. The private sector has a high cost of service to the people; most of the population cannot afford the services of private sector. The citizens of South Africa generally take private insurance policy cover so that they can receive the best health care services of private sector (Ford and et. al., 2018). In the case of inequality in services, the public health care system of South Africa minimizes the cost of health services so that economically poor people can attain a better health care system. The government implements plans in which they reduce the cost according to the income of individuals. The funding for healthcare system for public sector comes from the government through taxation. The government plans to implement the national health insurance (NHI) scheme so that the quality of health care can be improved and the required citizens can get affordable services. The public sector is highly subsidized by the government by making the services cheaper.

There are lots of effective ways that can be used to implement the services in health care. Some ethics rules and regulations are also considered in health care system so that the human rights of individual can be protected. There are many issues faced by the citizens of the country (Denny and et. al., 2017). Included are the high cost of services and medication which can't be afforded by the poorer class of people. The government takes action regarding this issue to develop the new strategies that can help the people to promote their healthy life. The health care system also consider the quality of health that are providing to the citizens. The NHI policy has the potential to support many people by providing them schemes so that they can reach to the services by suitable vouchers.

The people can access to the primary health services by the permit of primary health insurance policy. The public sector at present does not have the capacity to cope with many citizens of the country- but the government is planning ahead.

1.4 Research Gaps

It is one of the most essential sections of research as it determined the problem that is needed to be addressed. Mainly, it is a systematized review that can directly research agendas in order to influence future activities and scope of the project (DeGhetto Gray and Kiggundu, 2016). The current investigation is based on the challenges confronting the implementation of universal healthcare in South Africa. It impacts of implementing clinical procedures and treatment methods while providing care services to wellness of citizens.

In health system of the given country, the leading operator of a usually low national life anticipation is a multi-faceted disease concern which is made up of TB, HIV/ AIDS, diseases associated with poor exercise habits and nutrition, as well as trauma and mental diseases from aggression or road mishaps.

The healthcare services in the nation are set to receive forceful modification. These crusades are fitting to address what has apparently become a national utterance over ineffective public healthcare services and pathless private healthcare. The approximate population of South Africa as they have to postulate with normally poor employment in the public sector or low-cost medical bills from private health facilities.

The public health installation stays the only choice for the more than cardinal of citizen. South Africa has the highest level of HIV in the world. TB stays on the leading cause of death and lifestyle diseases increase (Gous and et. al., 2016).

The challenges to bury sectoral work is known were deficiency of communication between sectors, problem represented roles. As well as each sectors perception of lack of activity from other sphere. Involved recognized the plan of action for addressing these challenges enclosed rising communication between sectors. To encourage leadership from all level and conventional intrasectoral kinship through suitable written concord.

Objectives of the Study

• To examine the basic understanding of universal healthcare.
• To evaluate the challenges faced in relation to implementation of universal healthcare in South Africa.
• To identify the effective ways of implementing universal healthcare.

Research questions

• How does the universal healthcare philosophy deliver the healthcare requirements for South Africa?
• What are the challenges faced in relation to implementation of universal healthcare in South Africa?
• How to identify the effective ways of implementing universal healthcare?

CHAPTER 2: LITERATURE REVIEW

2.1 Delivering the healthcare requirements through universal healthcare philosophy for South Africa

As per the views of Young (2016), the sector associated with health care related to such systems where the prime aim of health providers to to render good health practices to all people living in the world. The health care system works globally by strengthening the health systems and by improving the health care services to all the citizens. They work on a strategy to provide the health care services equally among all people of country. As per views given by Conley and Durlak (2017), the universal health care works to provide the health services by increasing the health systems across the world. Recently, the universal health care is the centre of among all which improve the stages of health services. They also help in distributing the health services to all ages of people.

The thoughts of Moyo and et.al., (2015), suggests that South Africa are working to develop such national health insurance policies which can easily recreate their individual health care body with universal health care. The national health care symbolise the policy which will help in reforming the health care system of South Africa. The policy of NHI are both applied on both public and as well as private sectors. The NHI provide funds to the citizen according to their health needs or requirements. The aim of this policy is to reduce the poverty and to address the inequalities of health care which are resulting from the previous years. With the help of this policy the health care services can be given through both public and private sector.

The aim of universal health care is to promote the health services by preventing illness and providing the appropriate medical treatment according to the cause of illness. Basically, the universal health care system uses two main criteria to improve the health quality in the country and it includes the financial insurance coverage and primary health care services. According to Lynette Reid (2019), the universal health care works on a plan that all people have right to receive the health services whenever they need and according to their necessity. This includes the rehabilitation and other treatment of effective quality. They also ensure that the treatment doesn't bring out the financial problems to the people. This health care works with NHI to deliver the care services by the reaching the services to the community and promoting the health to them. The universal health care works on idea in which they provide services in packages of services such as mental, maternal, reproductive, child and paediatric health care services.

The health system of universal health care stands on two components such as the quality of care and financial amount. Their financial fund includes the providing the financial funds to the people by delivering the services in package. The individual can receive the services by packages which can be available through insurance and from the flourishing private sector.

In South Africa, the right of health care is enclose in the constitution. The philosophy of UHC consist of providing care to the population who has higher needs of care and to those who are facing many problems regarding care and money. These people can be identified on the basis of the principles of NHI so that only vulnerable people will be prioritized. The UHC ideology depends on the availability of services and on the people using the NHI policies. Shane D. Courtland (2019) states that it includes the models which are proposed by UHC are not indifferent and allow to the people so that they can also take advantages the services of the private health care sectors. The UHC loaning itself in the policies of economic relaxation. With the pressure of neo-liberal health policies, the health care services provide in equality and efficiency to the population within the pressure of these policy. It prevents the care to reach the health to public health care services.

According to the perspective of Cotlear and et.al., (2015), the strategic planning of delivery of health by UHC majorly comprises of protection, household planning, immunisation, prenatal care, attention on communicable disease as well as non-communicable disease. It also includes access to the various severity of health care needs such as hospital, medicine, security of health care services. The universal health doesn't provide effective care from collaborating with NHI as they government and political parties of South Africa have improper management. The political parties take poor political decisions regarding the health of citizens and due to their improper management the South Africa rank amongst the poor country among the other countries. The service provided to the citizens compares in supplying of health care services, safe environment, human rights, education, tolerance and houses. There are lot of mismanagement occur in the country due to the presence of poor political system in the country. The shortage in the professional staff members withdraw from the hospitals as they are not being paid and as a result there is a delay in the health care provided to the people. With the help of UHC, recently the care that is being delivered to the South African people is increasing. The UHC is based on the WHO constitution which declares the human rights policy in the country. As mentioned by Thomas K Thomas (2019), but due to the political situation of South Africa they are not delivering the right amount to the staffs which are enforcing them to back out from the providing services. From this delay in operation and treatment occur which lead to increase in chances of infection in the community. The difference in the health status and service delivery can occur within the different districts and realizable tensions can be seen between the ideologies. So, in South Africa by accenting the districts the resources of health can be provided to other districts that are underserved.

2.2 The challenges faced in relation to implementation of universal healthcare in South Africa

When the view pointy of Zweigenthal, London and Pick (2016), were seen that it was shown that, all citizens can get easy access to Universal healthcare so that good quality and healthy practices can be accessed for improving their well being. Government usually offers it to every individuals regardless of their financial conditions. It is also known as social health insurance that create justice for citizens of South Africa both socially and economically. However, to implement this particular program there are some common challenges emerging. Some of them are discussed here.

2.2.1 Challenges

Government of South Africa is determined to develop an equal health reform and to ensure that every citizen is receiving equal healthcare services in the country. As per views of Kartik K.Venkatesh, Anjali J.Kaimal and Laura E.Riley (2019), primary healthcare is the most important aspect in a public healthcare sector. To implement such sort of services in the country, a lot of challenges come in a way such as lack of resources, lack of care practitioners, individuals own beliefs and perception, society and many more. One of the most prior challenge is to make citizens aware about the program and to make them know that it is a fundamental right to basic receive basic healthcare services including autonomy and dignity in healthcare. There is a lack of planning for implementing this program to the citizens of South Africa. Rather than that, other challenges which are faced by UHC are discussed here.

Moreover, as per Yeates and Pillinger (2018), due to the factor of disproportionality among the governmental and private health care sectors, which is the main cause of varying services and facilities in South Africa. Private healthcare sectors being richly resourced faces less number of challenges rather than government where there is scarcity of proper resources. Alicia Ely Yamin (2018) states that it will cause some difficulties in implementing Universal healthcare coverage as resources are the most important aspect of delivering quality care services to the individuals. Secondly, there is a challenge to ensure that this particular program is covering all the informal sectors. Thirdly, private healthcare sectors are usually involved in providing guidance for quality care of services; due to which this particular sector is gaining lot of profit and is able to connect economically and politically. However, this is beneficial for individuals who can afford this services and who are financially stable. This healthcare system often leads to an unfair treatment and large number of population of South Africa remain untreated due to financial problems. There is a lack of resources and healthcare practitioners that can provide healthcare services to the citizens of country. Moreover, when the perception of de Waal and et.al. (2018), were analysed, deficiency of health care practitioners would be actually very challenging so as to implement Universal healthcare program. Some of the decisions and guidelines set by government and politicians will lead to less progress in the implementation program. Additionally, the major issue in declining of health care services to individuals is shortage of human resources and their uneven distribution in public and private healthcare sectors. Economical and political uncertainties are largely faced by government hospitals and also demands for healthcare facilities from government is increasing day by day but financial power and support of individuals are diminishing constantly. Furthermore, lack of resources and facilities such as electricity, water, food and most importantly infrastructure is causing disruption in delivering healthcare services to the individuals. Lack of equipment and machines in government hospital is also a major issue in applying universal healthcare services which is mainly due to unstable exchange rates.

Less utilization of equipment and technologies in healthcare sectors will lead to delay in treatment and surgeries. As per opinion given by Barron Peter and Sherman Gayle (2019), low quality of reporting and record keeping methods can cause number of issues and even unnecessary delay in treatment of hospitals or in healthcare organisations. Infrastructures that are developed poorly can cause problems or issues within the premises and may lead to create a negative image amongst individuals. Meanwhile, long waiting times can lead to delay in delivering health care services to the citizens of South Africa and increased cost can cause some health related issues in individuals as they are less likely to be financially stable. Less motivated multidisciplinary teams and workload on care practitioners due to burden of diseases like HIV or TB within individuals can sometimes lead to improper or wrong treatments. Lack of advices from healthcare professionals can sometimes be challenging for the care practitioners for making an appropriate decision for service users or patients.

2.2.2 Pressure on public healthcare sectors

Healthcare in South Africa is usually in the state of chaos with large number of inequalities between public and private healthcare sectors. As per the views of Moyo and et. al., (2018) affordability plays a crucial part in such sort of discontinues in care settings which is deliver to citizens of the respective country. The government legal policies within South Africa states that each and every individuals should have an access to healthcare services even including reproductive healthcare. Healthcare practitioners cannot refuse any individual for providing treatment in case of an emergency. Government is making strict rules for measuring the quality of care services being provided to individuals. Regardless of this, there are still major challenges being faced by Universal healthcare system. Less maintained records and no confidentiality and privacy in record keeping process would lead to ineffective operations with in sectors and abuse of health systems. As mentioned by Verusia Chetty, Jill Hanass-Hancock and Hellen Myezwa (2019), the limited account of access of primary, secondary and tertiary healthcare facilities in South Africa lead to spread of number of diseases and emerging health related issues. Almost around 43% of the healthcare posts are vacant in public health sectors due to less amount of funding in the government sectors. As per the perspective of Yamin,2017 hospital premises and emergency rooms are flooded with a wide range of population due to low level of maintenance which eventually leads to conflicts between persons and could result in unhealthy environment for service users.

Government has low level of clinical practices and care practitioners are less skilled with limited amount of information about healthcare services. Thus, lack of staff members will lead to many serious consequences such as less training, demotivation within the staff members and no infection control. Such common challenges are mostly face by Universal healthcare system when they implement their healthcare services to the individuals.

3.3 The effective ways of implementing universal healthcare

Universal health care defines that all the communities and every population receive various type of health support and care that are essential without facing any kind of financial and money related hardship. As per the views of Jesus and et.al. (2017) such sorts of healthcare services covers each and every aspect of people from treatment, diagnosis, rehabilitation to health care promotion and prevention. Universal health care ensures that each and every person who are being addressed from any deadly and high mortality causing diseases have access to such type of care and services. They further also monitor and guarantee that the type of services which are being provided are good enough to treat and improve the quality of the life.

3.3.1 Importance of Universal Health Care

Accomplishing universal health care is has been considered as one of the biggest mission of the countries across the world while adopting and setting the goals of Sustainable Development. The countries which are successfully moving towards achieving overall progress in universal health care are also moving ahead to reach other health associated marks and aims. The pressure of adopting such measures is high in countries because a healthy body is being considered as an asset to the world. It also allows to make children and adults aware about their health conditions and assist family members to escape from spending money in hospitals and thereby rendering them the chance to help in building economic development and long term planning. As per the perspective of Cashin and et.al. (2017) the action of protecting individuals from paying expensive bills for care and lowers the risk of making individuals of being financially unstable and poor. Sudden and unexpected illness results in loss of future savings and life assets which further destroy the career and future of their children and family.

3.3.2 Efforts to implement Universal Health Care

The countries are already making efforts to implement and shape the health care universally. Such countries may take more actions and steps to move fluently and rapidly towards its progress and also to make more amendments and positive alteration to maintain and improvise the quality of support. It is observed that providing medicines on cheaper price create problem for government because these care services are not available according to high demand of them. It is essential for government and healthcare sector authorities make effective strategies of providing services by managing them equally among citizens for their welfare. Thus, the government forces the private hospitals to decrease their cost for necessary health associated services especially to those people who cannot meet the demands. It has been observed that through some set of regulations and guidelines, the price and expenditure of high quality services and medicines are negotiated by the government.

Progressing towards universal health care in all the countries is essential by maintaining vigorous financial make up. It has been shown that when the family member of poor people and community gets ill, they have to spend lots of money for health services and cost on treatments and medicines. As per the perspective of Fusheini (2016), families and persons who are above poverty line also get exposed to financial hardship because of chronic diseases. Funds from mandatory insurance may contribute in lowering the risk of getting into financial crisis and aids in maintaining stability financially. The factors like availability and capacity of the health and social workers to promote and support people centred collective care is important in positive health outcomes and coverages.

Prior investments in primary health care field is the key in achieving universal health care around the globe. More investments in increasing workforce and deliverance of quality services has been considered as a most cost managed and effective way to assure necessary health care. Good governance by the health practitioner and care providers help in implementing the universal health care by ensuring the safety of patients, properly allocating roles to other team members and carrying out better ways to manage the financial crisis.

Another way may be to control the flow of service, equipment and medicine purchase according to the disease and required treatments. Best hospital procurement practices must be used so as to improve the condition of patients coming in emergency and unscheduled check ups and diagnosis. Current and innovative health technologies which do not need regular checks and can be operated with minimal requirements. As per the views of Suphanchaimat and et.al. (2016), such kind of techniques can be utilize to lower the cost for maintaining the equipments up to date and to provide devices and systems in order to solve health related problems and enhance quality of care services. Another way to implement the universal health care is to furnish well functioned information system of health. Such measure helps to deliver the analysis, manufacturing, diffusion and use of authenticate and timely information on all types of health determinants, status and the workforce performance.

3.3.3 Universal Health Care in South Africa

The countries like South Africa have been suffering from deadly diseases like malnutrition, HIV/AIDS, mental health problems, undernourishment, cancer, thus, such system of health care is advantageous and beneficial. The requirement of efficient public service with professional and skilled health care practitioner are supported by National Development Plan (NDP), which defines the condition of South Africa and states that the major challenge is this country is poor quality of health services. So as to improve the condition of such people competent and trained medical workers are essential to achieve positive health associated outcomes.

The implementation of high health care system in South Africa helps their citizen to utilise such services without getting worried about their expenditure regardless their conditions economically. Various and advanced clinical services have been provided in respect to protect and safeguard the future of the country by protecting the children and adults in all possible health related way. Such universal care will also encourage equality and rights to health at global level. It has been analysed that whole population of South Africa will be positively effected by proposing and implementing universal health care system which is not at all bias on religion and status of people and purely based on improving the life quality.

CHAPTER 3: RESEARCH QUESTIONS

3.1 How does the universal healthcare philosophy deliver the healthcare requirements for South Africa?

The Universal healthcare system is required to be strong enough to support people to overcome with disease to become healthy. It is necessary to use the political philosophy of health care to provide sufficient resources and advanced technology to hospitals in each country so that every person will get treatment on time, however, it is necessary for evaluating resources and staff in terms of attending patients to solve their health issues. Meanwhile, it is required for political parties and government authority of South Africa to put efforts to strengthen the health care system of country so that people will get care facilities easily. It is necessary to provide proper amounts of fund and other resources so that professionals can deliver accurate medical and treatment on time for wellbeing of citizens. It will facilitate to maintain appropriate health status of entire population which impact positively economy of the country.

3.2 What are the challenges faced in relation to implementation of universal healthcare in South Africa?

The challenges in context of implementation universal health system in South Africa involves various factors including funds, resources, staff and many more. It involves the major challenge of funds because very small or large change in healthcare system of country need a huge amount of money. However, it is known as the major challenge that can be overcome with proper support of government and local authorities in terms of gaining funds to apply desired modifications in health system. It includes another challenge of staff because their develop resistance towards adopting new changes or technologies as it requires extra efforts and time. It is necessary to conduct proper management of time to arrange learning session for care professionals so that they can easily adopt universal healthcare system to deliver more effective medical facilities for welfare of people.

3.3 How to identify the effective ways of implementing universal healthcare?

There are number of effective ways and strategies which provide support to apply universal healthcare in South Africa. It is necessary to make proper funds to apply advanced technology which improve efficiency of professionals to make possible for every individual to gain access to required health systems. However, government can make local centres for care services to different areas of country so that epidemics of diseases can be controlled easily. In addition to this, it is necessary to make sufficient recruitment of healthcare professional to make sure that every geographical area has enough medical practitioners to solve health problems of respective population living in particular place.

CHAPTER 4: RESEARCH METHODOLOGY

4.1 Introduction

Research methodology can be described as a part of specific processes and techniques that helps to determine, select and analyse gathered data. It is necessary for researcher to select more effective as well as efficient methods and procedures for carrying out appropriate study about particular topic (Harrowing and et. al., 2018). However, it will focus on research designs and philosophies which are accurate in context of this investigation and which facilitate to attain correct findings. It consist the criterion of using desired source of data collection and sample along with discussing about ethical consideration of study.Take online essay help from top essay writers!

4.2 Research Onion

Research methodological analysis mention as an effective procedure used by research worker to collect proper message or information about the tract of topic or study. It is just about crucial chapter which intelligibly report the methods of research practical to conduct the study. This researcher determine how the verifiability are collect, shown and examined of crucial message, data address and investigated questions (Ledford, and Gast, 2018). Main reasons and consideration for the data is origin, research arrangement, data aggregation method, research device, research strategy, analytical techniques, research reliability, data presentation techniques and validity used are given. For this, research onion is included as useful hypothesis used by research worker to determine best formulation of enquiry. This theoretical account has various profane which are shown as under:

Philosophy to Saunders research onions

The research philosophy is the set of impression of nature of realism existence for the investigated philosophy as well as it is the knowledge of nature. It is generally analysed in status of Epistemology, Ontology, Axiology. It is the first top most layer of the Research Onion and it effect the collection of data. The three main philosophies are important in this procedure.

• Epistemology- The regarding knowledge is concerned with acceptable questions that are depend on it obtain (Bresler and Stake, 2017). It usually answer the questions starting with what and how. Intuition, sensation, reasoned, perception, faith are included as the source to knowledge as per Epistemology.
• Ontology- It is the branch of metaphysics which is associated to entire nature which is obsessed with the study of reality that exhibit reality. It clear the difference between how perceive reality and occurrence of reality. It includes objectivism, constructivism, pragmatism.
• Objectivism- This method is derived from idea and thought that are come up from knowledge which are attain by human objective values which develops from reality of obstinate nature (Wiek and Lang, 2016). The actuality is not dependent on the ideas of any particular social factor. In this research example is a real phenomenon of social actors.
• Constructivism- It focuses on how knowledge of bodies come to be thoughts are contrasted by human decisions and interactions. In this, the reality is dependent on constructed by social actors.
• Pragmatism- The philosophic standpoint is link between theory and prcatices. It helps in maintaining objectivism and constructivism in an appropriate manner in order to achieve any kind of investigation (King and Mackey, 2016). Example of this is law of gravity.
• Axiology- It assist to learn opinions and valuables which effect the accumulation and examination of research. The thoughts of individuals have on analysing and collecting of investigation. It necessary to assist to realize people opinion matter a lot while carrying out a enquiry.
• Strategies to Saunders research Onions- The research strategy is refer as how the researcher inclined to carry out the work. It consider as different approaches like experimental, action, case study, interviews, systematic literature review, surveys.
• Experimental- It mention to developing a investigation procedure that analyse the results of experiment against the expectable outcomes.
• Survey- It includes in finest strategy which is also related to approaches like deductive approach (Krishnaswamy, 2016). The study tend to be used in quantitative projects. It observe conducive uncertain various data.Worried about assignment help? Take Expert's Help Now!
• Case Study- This research is focuses on the design which is given for specific examples of real people or case in actual conditions.
• Action Research- It mentions to deal with a specific problem in particular status. This method is used because it starts with scope up of a clear-cut objective. However, this scheme is used chiefly to search the solution which can be used to solve definite issues.
• Archival Research- This conclude on the content from existent data and hide documents and data. This strategy can confront barriers that are diving firstly in head as value of messages can be accessible in instant problems with accuracy (Rosskam, 2018).

Choice to Saunders Research Onions

It is the fourth layer of research onion is taken up with quantitative and qualitative methodological analysis. It assist to know whether it is better to reaper both. In reported to Saunders there are three consequences which consider as Mono, Mixed, Multi research methods choice or formulation. There are quantitative investigation which are associated to numbers and measurements (Pruzan, 2016). On the other hand qualitative taken up with rich data regarding as personal, opinion, descriptive.

Mono method- This takes place when the research worker goes just about accumulating either quantitative and qualitative data supported on the decisions made in the last stages of study.

Mixed method- A investigator collects both data with an intention to use those in balanced in the study of research, analysis and data collection as it called mixed method. It is kind of well known structure which endeavour to complement both data due to defeat of limitations as per person method which will be used in this study.

Multi method- It refer both quantitative and qualitative collection of data techniques are uses. Nevertheless, examination of the accumulated data is done by using one visual aspect only.

Research philosophy: There are two types of researcher philosophy which is interpretivism and positivism. As per this subject, the interpretivisim philosophy help extremely in assessing content and data practically (Hickson, 2016). On the other hand, positivism philosophy which will not proper for conveyance out inquiry activity in efficacious a systematized way.

Research Approach: It include Inductive and deductive are better formulation of investigation used by research worker to request choice and in deep message about the examination. Reported to the topic, inductive approach is more appropriate because it will assist an researcher to collection suitable content about the theme and increase better conclusion for advance research.

Research Choice: There are two types of fundamental research occur that is quantitative and qualitative research. In qualitative research, data and information are gather through superior ways. In addition to this, the quantitative research refers to accumulation of content through various numbers, facts and figures (Quinlan and et. al., 2019). Both type of investigation are necessary but reported to the work, quantitative research is more appropriate and precious because it will help an researcher to determine faithful consequence from chosen responder.

Time Horizon: It including as an significant implement of investigation which will assist an research worker to examine protrusive and termination time period for activities of research. Gantt chart presented as an effectual graphical demonstration tool which will help an researcher to accomplished each act of enquiry within given period of time.

Research design: It depicts as an impelling construction or plan for a investigation or a list of process and description for arranging and controlling a research project. The function includes master and necessary programme of methods that are gathered and analyse messages with the help of determination maker (Clandinin, Cave and Berendonk, 2017). There are three types of exploratory, descriptive, including research design.

All are important but as stated to the topic, prescriptive design is more suited because it will assist to represent a suitable visibility of person, situations and circumstances. It permit for faithful and in-depth judgement of components and changeable of the group of population.

4.3 Research philosophy

It is the topmost and first layer of research onion. This is a belief about the manner about a phenomenon that should be analyse, assemblage and used. There are two types of research philosophy occur which are positivism and interpretivism (Ndlovu-Gatsheni, 2017).

In according to subject, interpretivism is linked with the perspective of idealism or used to group together diverse approaches, hermeneutics, phenomenology, social constructivism. It is very crucial for the research worker as a social actor to understand deviation in between of individuals. This is mainly focus on meaningful state many types of methods due to indicate various prospect of the problems.

The approach of interpretivism is based on realistic approach of data aggregation for examples observations and interviews. In this type of examination, come forth normally towards the last of the procedure of research.

On the other hand, positivism is based on the thought that scientific knowledge is loyal or acceptable to around the world. With the help of actual cognition of belief, some inquiry questions and can be hypotheses by experiment (Leavy, 2016). The structure of investigation is bring forth by philosophical position is something that can be double by some different investigators. Moreover, with correspondent quantitative results originate from statistical examination.

4.4 Research Approach

It consist to be the second layer of the research onion and exhibit the formulation that a scientist could repair to when managing any kind of research. It is process and plan which exist steps of wide assumptions. In a detailed method of analysis, interpretation, data collection. This research approach is divided into two types that is deductive, inductive.

• Deductive research approach- A developed set of conception for dissertation which needed to be rejected or confirmed in the duration of research procedure as it has impact of migration labour. The investigator who uses this can begin their research with theory which is tested by data collection (Daniel, Kumar, and Omar, 2018). In the end, the study is determined from accumulated data either it official or ignore the possibility or question.
• Inductive- This kind of thinking or approach is frequently used or assistive. When the little type of inquiry is present on atopic in a different deductive approach, the investor need to move to locate tendency from inquiry of research in order to examine by description and observation (Ahmed, Opoku and Aziz, 2016).

In this report, it will discussed about the inductive research is rarely associated to qualitative research.

4.5 Research Design

Research design refers to a combination of appropriate techniques and methods selected by investigator combine different elements of the study in a logical way. It can be classified in three categorise such descriptive, exploratory and experimental research design from which specific one can be chosen by researcher (Engelman and et. al., 2016). Initially, descriptive research design has a criterion to consider bulk of information through online survey. In experimental research design is used to abolish a relationship between the affect and cause of conditions. It is accidental and casual research design where the result caused by independent variable on the mutualist changeable is determined.

For example, in the impact of an independent variable like cost on a parasitic covariant such as emotional state of clients or sort loyalty is monitored.

In Exploratory research, the examination design research worker by ideas including opinions that are important as their first place occur on private disposition on a subject (Kao and et. al., 2016). The explanation about the unexplored aspects of a theme is render along with information about what, why and how affiliated to the question of enquiry.

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4.6 Data Source

4.6.1 Secondary Data

The research believe on secondary and primary both data or message due to come up with verifiable discovery. Origin is applied to compile secondary collection were representation investigation depend from unpublished and published administration documents and susceptible accompanying with internal journals of business, literature etc. These are the major informant which assist research worker to collect deep information for their survey (Berger, 2018). For the both data sources are crucial for investigator to collect appropriate content about the examination.

4.6.2 Primary Data

Primary data refers to collected for the first time in the region. In study of Primary Data will be deepened utilising questionnaire interviews or questionnaire. Moreover, secondary data which is collected to causative another than the use of original data. There are various kind of data collection techniques are questionnaire, observation, interview, including etc. All are necessary for research worker to roll up correct message just about the subject. Reported to the topic, questionnaire will be used by researcher to gather dependable and legal data about the survey.

4.7 Data Collection Method

In context of this investigation, primary and secondary, both data collect methods were used as they are suitable for gathering relevant information. It includes primary sources of data collect in which questionnaire is used for collecting data from respondents to interpret accurate findings. Along with this, secondary sources were used to conduct literature review with the help of reviewing views of different authors who carried out study on similar topic. The Suitable, clear and correct structure of existing content were designated out of the respective status presentation of data. There are some manner of information or data presentation with regard as bar charts, line graphs, tables and pie chart. The whole are primary mode which is used by investigator to presentation of data, associated with the subject. It is fundamentally three types of techniques for example regression analysis, inductive investigation, deductive examination. The inductive technique or approach are applied by research worker in their subject or topic as all important but this is most suitable accordant to their topic (Long, 2016). As it will assist an researcher to examine secondary statement and assume a feel of the conditions on the ground and so know the nature of issuance much in a better ways.

4.8 Population and sampling

A sample is a unit in learning in which data is acquired. This type of sampling are separated into two parts, that is Non probability and probability sampling method. The sampling process consider as judgemental sampling, systematic, stratifies, random. For the aim of this research, stratified as well as judgemental random sampling were applied to examine the accurate size of sample. Chief intellect is behind choice of stratified sampling as it guarantee an equivalent content of overall known section. The judgemental sampling also plays an important role in this as it assure about improvement of information and time as the data sought from responders who have their message about investigation (Worthington and Bodie, 2017). It mention to a assortment of option techniques in which social unit of sample are designated by opportunity but with a famous amount of choice. Random sampling is captious constituents to entire examination design of investigation. Basically is used to remove a smaller sample size from a increasing population as well as it is use to look into and make generalizations about bigger unit and group. Therefore, the probabilistic sampling method has been considered by using its specific method of random sampling to collect sample for this research. The participants were selected by conducting interview of target population by approaching suitable candidates and collect sample of 60 respondents.

4.9 Ethics, reliability and validity

In primary investigation, the production of survey can be secured which are reasoned to applicable of research ethic (Park, 2017). There are primarily three rules as well as principles that were applied in enquiry such as; informed consent, anonymity, confidentiality, etc. For anonymity, information of all contestants were not enclosed and not connected to any other primary investigation. For informed consent, they should gives correct data content about the inquiry verifiable to each associator that will help them in complementary research consistently and effectual. There are various disadvantage or problems which is confronted by research worker while explicate aims of objective and research utilising data collection methods, development the of size of sample, deficiency of former work in the area of research, scope of discourse and discussion and many different accumulation of research. All are chief drawback which will effect on scientist while doing each act which is related to investigation. The reliability and validity are two investigation that is rely research device which is consider as questionnaire of research (Clark and et. al., 2017). It is crucial equipment that will assist a research worker to collect data which is appropriate and correct content just about the topic.

4.10 Rationale

It is used for research, its a set of causes offering by research worker administrating more enquiry into a particular objective either library, descriptive, experimental research. It is the reason of the project or study. In opinion, research should be structured as rationale, observation, objective, hypothesis, methods, conclusions, results etc. To write rationale, it should first write a background on what all investigation has been done on a study, project topic. It is very essential to able and explain the importance of research conducting by giving valid arguments. The inquiry needs to contribute to the elimination of a gap in the literature. Furthermore, it can managing to solved a particular issues.

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CHAPTER 5: RESEARCH RESULTS

5.1 Introduction

Data analysis refers to the process of evaluating the collected data and analyse it to gain outcomes of the study in relation to given problem of investigation. It includes the utilisation of various data analysis methods which is most suitable to interpret the findings on the basis of gathered information related to the selected topic. This research will focus on thematic analysis for interpreting the findings of the research in relation to health system of South Africa.

5.2 Data collection for quantitative analysis

Frequency Table

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